Reviews about Using Prosody to Treat Other Skills

Last update: August 21, 2017

USING PROSODY TO TREAT NONPROSODIC TARGETS

  

  1. Full reviews can be accessed by clicking on (or cutting and pasting) the address at the end of each summary.
  2. This table can be used to locate reviews about different interventions in which prosody is used to treat nonprosodic target outcomes.
  3. Scroll down to the outcome that you are interested in treating.
  4. The table is organized by outcomes which include
  • ACADEMIC OUTCOMES
  • ACCENTEDNESS OUTCOMES
  • AFFECT (nonprosodic aspects of affect) OUTCOMES
  • ARTICULATION/SPEECH SOUND OUTCOMES (see also Phonological Outcomes)
  • ATTENTION OUTCOMES
  • CHALLENGING BEHAVIOR OUTCOMES
  • COGNITION OUTCOMES
  • COMPREHENSIBILITY (EASE OF UNDERSTANDING)
  • COMPREHENSION OUTCOMES
  • CONFIDENCE OUTCOMES
  • EFFECTIVENESS OUTCOMES
  • FLUENCY/STUTTERING OUTCOMES
  • FUNCTIONAL USE OF WORDS OUTCOMES
  • GENERAL COMMUNICATION SKILLS/FORMAL TEST OUTCOMES
  • GESTURING OUTCOMES
  • IMITATION OUTCOMES
  • INITIATION OF SPEAKING TURNS/CONVERSATION OUTCOMES
  • INTELLIGIBILITY OUTCOMES
  • INTERACTION OUTCOMES
  • LANGUAGE DEVELOPMENT–GENERAL
  • LITERACY OUTCOMES
  • MEMORY OUTCOMES
  • MLU/WORDS PER MINUTE OUTCOMES
  • MOTOR SKILLS
  • MORPHOSYNTAX OUTCOMES
  • NAMING (see  Functional Use of Words and/or Production of Words)
  • NARRATION (Story Telling/Retelling)
  • NORMALCY/NATURALNESS OUTCOMES
  • ON-TASK BEHAVIOR OUTCOMES
  • ORAL MOTOR SKILL OUTCOMES
  • PHONOLOGICAL/PHONOLOGICAL PROCESSES OUTCOMES (see also Articulation Outcomes)
  • PICTURE DESCRIPTION OUTCOMES
  • POINTING OUTCOMES
  • PRAGMATIC OUTCOMES
  • PRODUCTION OF PHRASES OUTCOMES
  • PRODUCTION OF WORDS OUTCOMES
  • PSYCHOLOGICAL STATUS OUTCOMES
  • RATE OF VERBALIZATION OUTCOMES
  • READING (see LITERACY)
  • REPETITIVENESS OUTCOMES
  • RESONANCE OUTCOMES
  • RESPIRATION OUTCOMES
  • RESPONDING TO QUESTIONS/COMMANDS OUTCOMES
  • SEMANTICS OUTCOMES
  • SINGING OUTCOMES
  • SOCIAL INTERACTION OUTCOMES
  • SPEECH SOUND OUTCOMES (see Articulation/Speech Sound Outcomes and Phonological/Phonological Processes Outcomes)
  • TURN TAKING OUTCOMES
  • VERBAL EXPRESSION OUTCOMES
  • VERBAL REPAIRING OUTCOMES
  • VOCALIZATION OUTCOMES
  • VOICE QUALITY OUTCOMES
  • VOICE ONSET TIME OUTCOMES
  • WORD/SOUND DISCRIMINATION OUTCOMES
  • WORD FINDING OUTCOMES

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ACADEMIC OUTCOMES

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Limited Evidence

 

Limited Evidence, minus

  • The authors explained the rationale for co-treatment of communication disorders by music therapists (MT) and speech-language pathologists (SLP) and described the strategy using a single case. The dependent measure was classroom engagement (Geist et al., 2008). Language Impairment; Children https://clinicalprosody.wordpress.com/2014/05/14/geist-et-al-2008/

 

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ACCENTEDNESS OUTCOMES

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Moderate Evidence, plus

 

 

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AFFECT (nonprosodic aspects of affect) OUTCOMES

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Strong Evidence, minus

  • The results of single subject experimental design studies indicated that both cognitive-linguistic and imitative intervention approaches were effective in improving the rate of correct productions of 3 affects/emotions: happy, sad, angry. The investigators provided thorough descriptions of both intervention procedures as well as the participant characteristics (Rosenbek et al., 2007). Expressive Aprosodia, Right Hemisphere Brain Damage; Adults https://clinicalprosody.wordpress.com/2015/01/21/rosenbek-et-al-2004/

 

Moderate Evidence

 

 

  • Using single-subject experimental design studies explored, the effectiveness of across-modal matching to sample intervention to improve the comprehension of affective prosody of Japanese children diagnosed was confirmed (Matsuda & Yamamoto, 2013.) Autism Spectrum Disorders; Children https://clinicalprosody.wordpress.com/2015/01/29/matsuda-yamamote-2013/

 

  • Single subject experimental design investigations revealed that a computer based intervention administered by a “tutor” was associated with moderate improvements on formal tests of facial affect recognition. There only was limited support for generalization to social interaction with peers (Lacava et al., 2010.) Autism Spectrum Disorders; Children https://clinicalprosody.wordpress.com/2015/02/28/lacava-et-al-2010/

 

Fair Evidence

 

 

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ARTICULATION/SPEECH SOUND OUTCOMES*

*(see also Phonological/Phonological Processes Outcomes)

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Strong Evidence

  • Both Rapid Syllable Transition Treatment, and the Nunffield Dyspraxia Programme-Third Edition resulted in significant improvements in outcomes related to correct speech sound production, articulatory groping, and articulatory consistency (Murray et al., 2015.) Childhood Apraxia of Speech; Children clinicalprosody.wordpress.com/2017/08/21/murray-et-al-2015/

 

Strong Evidence, minus

 

 

Moderate Evidence, plus

  • Three of four single subject experimental design investigations resulted in overall improvement of the production of speech targets. The perceptual measure involved a combination of speech sounds, lexical stress, segmentation/concordance (Maas & Farinella, 2012). Childhood Apraxia of Speech; Children https://clinicalprosody.wordpress.com/2014/08/12/maas-farinella-2012/

 

 

Moderate Evidence

 

 

 

Moderate Evidence, minus

  • This Systematic Review (SR) with broad criteria is concerned with a variety of treatments and outcomes. The authors of the SR rated sources for quality of certainty of results. The source that targeted vowel duration was rated as Suggestive (Murray et al., 2014.) Childhood Apraxia of Speech; Children https://wordpress.com/post/clinicalprosody.wordpress.com/1329
  • This comparison study (not an intervention study) indicates that rhythm intervention procedures are central to improving articulatory accuracy rather than music based intervention (Stahl et al., 2011) Nonfluent Aphasia; Adult https://clinicalprosody.wordpress.com/2014/03/09/stahl-et-al-2011/

 

Fair Evidence

Fair Evidence, minus

 

Limited Evidence, plus

  • Use of visual (oscilloscope and intraoral pressure) feedback shows promise for increasing normalcy ratings of some (but not all) Ps’ articulatory precision (Caligiuri & Murry, 1983.) Dysarthria; Adult https://clinicalprosody.wordpress.com/?s=Caligiuri

 

 

 

 

  • These case studies provided variable support for an intervention to improve contrastive stress, voice quality (pitch and loudness), articulatory precision, and naturalness but not verbal repairing in speakers with MS (Hartelius et al., 1997.) Multiple Sclerosis; Adult https://clinicalprosody.wordpress.com/?s=Hartelius

 

 

Limited Evidence

  • This Narrative (or Traditional) review of the literature contains reviews of several investigations suggesting that the inclusion of music/singing in intervention directed toward the production of speech sounds can be associated with improvement (Michel & May, 1974.) General Language Impairment; Children https://clinicalprosody.wordpress.com/2016/04/27/michel-may-1974/

 

  •  This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes. The outcomes associated with apraxia of speech improved (da Fontoura et al., 2014.) Aphasia, Adults  https://clinicalprosody.wordpress.com/2016/12/05/da-fontoura-et-al-2014/

 

Limited Evidence, minus

  • Illustrative case studies provide initial limited support for the use of modified melodic intonation (MIT) therapy in conjunction with other speech therapies to increase production of correct consonants as well as accuracy of articulatory sequences (Helfrich-Miller, 1994.) Childhood Apraxia of Speech; Child https://clinicalprosody.wordpress.com/2013/10/27/helfrich-miller-1994/

 

 

  • This traditional narrative review provides a guide to incorporating Lee Silverman Voice Treatment (LVST-Loud) into telepractice and reviews research documenting its effectiveness for articulatory precision as well as its costs and P satisfaction (Theodoros & Ramig, 2011) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2014/05/23/theodoros-ramig-2011

 

 

 

Minimal Evidence

  • These case studies yielded minimally applicable clinical results because the sessions were very brief. The perceptual measures of clear articulation improved following both interventions—Lee Silverman Voice Treatment and intonation only therapy (Kobayashi et al., 2004.) Dysarthria; Adult https://clinicalprosody.wordpress.com/2013/11/13/kobayashi-et-al-2004/

 

 

No Intervention Evidence Provided

 

 

Evidence contraindicates the use of the intervention for the specific outcome(s)

 

 

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ATTENTION OUTCOMES

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Moderate Evidence, minus

  • This investigation demonstrates the effectiveness music therapy in improving attention in developmentally delayed children from Taiwan who were speakers of Mandarin Chinese (Lee, 2008). Speech Impairment, Language Impairment, Developmental Delay; Children https://clinicalprosody.wordpress.com/2014/07/23/lee-2008/

 

Fair Evidence, plus

 

Fair Evidence

  • Overall results of 2 Experiments involved French children diagnosed with reading impairments treated with Cognitive-Musical Training (CMT) indicated improvement in measures of auditory attention and response sets (Habib et al., 2016.) Literacy Problems; Children  https://clinicalprosody.wordpress.com/2017/03/12/habib-et-al-2016/

 

Limited Evidence

  • This Narrative (or Traditional) review of the literature contains reviews of several investigations suggesting that the inclusion of music/singing in intervention directed toward attention can be associated with improvement (Michel & May, 1974.) General Language Impairment; Children https://clinicalprosody.wordpress.com/2016/04/27/michel-may-1974/

 

Contraindicated by the Evidence

  • Overall results of 2 Experiments involved French children diagnosed with reading impairments treated with Cognitive-Musical Training (CMT) indicated no significant improvement in measures of visuo-spatial attention (Habib et al., 2016.) Literacy Problems; Children  https://clinicalprosody.wordpress.com/2017/03/12/habib-et-al-2016/

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CHALLENGING BEHAVIOR OUTCOMES

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Moderate Evidence

 

Fair Evidence, plus

 

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COGNITION OUTCOMES

________________________________________________________________

 

Moderate Evidence, plus

 

Fair Evidence

 

 

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COMPREHENSIBILITY (EASE OF UNDERSTANDING) OUTCOMES

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Moderate Evidence, plus

  • Four single-subject experimental design investigations revealed that ratings of ease of understanding (comprehensibility) improved following the treatment that included both prosody and segmental targets (Behrman, 2014.) Second (or more) Language Learner; Adult https://clinicalprosody.wordpress.com/2015/02/11/behrman-2014/

 

Fair Evidence

 

 

 

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COMPREHENSION OUTCOMES

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Moderate Evidence

  • Moderate improvement in comprehension of read stories during expressive storybook reading, as assessed using cued recall. This is not an intervention study but it is clinically related (Mira & Schwanenflugel, 2013.) Typically Developing; Children https://clinicalprosody.wordpress.com/2013/12/27/592/

 

 

Moderate Evidence, minus

 

Fair Evidence, plus

 

Fair Evidence

 

 

Fair evidence, minus

 

  • The results of this small group investigation suggest that a music-based intervention to improve expressive language in preschool children was successful in improving RECEPTIVE vocabulary scores (Hoskins, 1988). Cognitive Impairment, Developmental Delay; Children-preschool https://clinicalprosody.wordpress.com/2015/10/16/hoskins-1988/

 

Limited evidence

 

 

Contraindicated

  •  This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes. comprehension outcomes did not improve tended as they were concerned with skills not targeted by AMIT such as comprehension of words, directions, or Inferences (da Fontoura et al., 2014.) Aphasia, Adults https://clinicalprosody.wordpress.com/2016/12/05/da-fontoura-et-al-2014/

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CONFIDENCE OUTCOMES

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Limited Evidence, minus

 

Contraindicated

  • The results of this case study suggest a combined intervention (Lee Silverman Voice Treatment and the Ryan Fluency Program) was moderately successful in improving severity and intelligibility as well as diadokokenesis skills. However, the patient’s self-perception of his communication skills decreased markedly (McMicken et al., 2011). Ataxic Dysarthria; Adult https://clinicalprosody.wordpress.com/2014/08/16/mcmicken-et-al-2011/

 

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EFFECTIVENESS OUTCOMES

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Fair Evidence

 

Limited Evidence

 

Limited Evidence, minus

 

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EYE CONTACT OUTCOMES

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Moderate Evidence

 

Limited Evidence

  • The authors provide objectives and strategies for clinicians wishing to include music in their treatment of children in the early stages of communication development. They report marked increase in eye contact (Witt & Steele, 1984.) Developmental Delay; Children https://clinicalprosody.wordpress.com/2016/10/13/witt-steele-1984/

 

 

 

Limited Evidence, minus

  • This descriptive case study describes a music therapy based intervention in which by following the child’s lead he was able to help the child establish a link between the child’s actions and the music played by the music therapist and eventually establish eye contact and beginning forms of interpersonal communication (Saperston, 1973). Autism Spectrum Disorders, Developmental Delay; Children https://clinicalprosody.wordpress.com/2015/01/13/saperston-1973/

 

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FLUENCY/STUTTERING OUTCOMES

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Moderate Evidence

 

Limited  Evidence

  • This case study explored the effectiveness of music in stuttering therapy. There was limited improvement in the overall measures of stuttering and variable changes in frequency and type of disfluences. For reading aloud, there was limited improvement in the rate of disfluencies and variable changes in the type of disfluency (Baumann & Palasik, 2017.) Stuttering; Adults https://clinicalprosody.wordpress.com/2017/05/28/baumann-palasik-2017/

 

 

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FUNCTIONAL USE OF WORDS OUTCOMES

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 Moderate Evidence

 

 

Limited Evidence, minus

 

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GENERAL SKILLS (including test instruments) OUTCOMES

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Moderate Evidence, plus

 

Moderate Evidence

 

 

 

 

Moderate Evidence, minus

  • This Systematic Review (SR) with broad criteria is concerned with a variety of treatments and outcomes. The authors of the SR rated sources for quality of certainty of results. The source that targeted performance on the PICAC (imitation, naming) was rated as Preponderant (Murray et al., 2014.) Childhood Apraxia of Speech; Children https://wordpress.com/post/clinicalprosody.wordpress.com/1329
  • The evidence was fair to weak but the program shows promise to improve self-rating on a communication adequacy questionnaire (McDonald et al., 2012.) Nonprogresssive Brain Injury, Affect Comprehension; Adult https://clinicalprosody.wordpress.com/?s=McDonald

 

Fair Evidence, plus

 

  • This single group investigation provides support for modified Lee Silverman Voice Treatment to improved performance on the Speech Assessment Scale (SAS) and on turn-taking counts from the Pragmatic Protocol but not for Visual Analogue Perceptual Rating Scale (VAPRS) and conversational initiation from the Pragmatic Protocol (Manor et al., 2005.) Parkinson’s Disease; Adult https://clinicalprosody.wordpress.com/2013/10/30/manor-et-al-2005/

 

Fair Evidence

 

Fair Evidence, minus

 

  • This case study provides limited support for an intervention which involves explicit prosodic targets and meta-awareness procedures in improving receptive and expressive performance on the Prosodic Protocol (Bellon-Harn, 2011.) Prosodic Problems, Adolescent https://clinicalprosody.wordpress.com/2012/11/20/bellon-harn-2011

 

 

Limited Evidence, plus

 

  • This case study described a case in which a woman with aphasia and apraxia profited from the addition of singing into her therapy programming when traditional therapy had failed. Evidence of progress took the form of improved performance on the Profile of Communicative Ability (Keith & Aronson, 1974.) Apraxia, Aphasia; Adults https://clinicalprosody.wordpress.com/2016/09/30/1340

 

  • These case studies provide limited support for using Melodic Intonation Therapy (MIT) as a warm-up prior to traditional therapy session to improve performance on some subtests of Porch Index of Communicative Ability in Children (Krauss & Galloway, 1982.) Expressive Language Delay and Childhood Apraxia of Speech; Children https://clinicalprosody.wordpress.com/2013/06/23/krauss-galloway-1982/

 

 

 

Limited Evidence

 

  • The results of this case study suggest a combined intervention (Lee Silverman Voice Treatment and the Ryan Fluency Program) was moderately successful in decreasing severity rating in a boxer with ataxic dysarthria. However, the patient’s self-perception of his communication skills decreased markedly (McMicken et al., 2011). Ataxic Dysarthria; Adult https://clinicalprosody.wordpress.com/2014/08/16/mcmicken-et-al-2011/

 

  • One P (of 4) who received traditional MIT did not evidence improvement on Porch Index of Communicative Abilities (PICA) scores from pre to post intervention; however, he did produce noticeable improvement on PICA modality scores and on cell scores as well as improvement on PICA scores 3 and 6 months post intervention. Three other Ps received a modification of MIT. Individual Ps’ change in overall PICA scores ranged from no to moderate improvement (Marshall & Holtzapple, 1978.) Aphasia, Apraxia; Adults https://clinicalprosody.wordpress.com/2016/10/31/marshall-holtzapple-1978

 

  • The investigator provides a clear description of music activities designed to facilitate spontaneous communication in preschoolers diagnosed as speech delayed. However there are some problems with this investigation comparing progress on a standardized test for Music Therapy and Speech Therapy with speech delayed preschoolers (Seybold, 1971). Speech Delay/Disorder General; Children https://clinicalprosody.wordpress.com/2014/10/06/seybold-1971/

 

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GESTURING OUTCOMES

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Limited Evidence, plus

  • This case study described a case in which a woman with aphasia and apraxia profited from the addition of singing into her therapy programming when traditional therapy had failed. Evidence of progress took the form of improved performance on the gestural portion of the Profile of Communicative Ability (Keith & Aronson, 1974.) Apraxia, Aphasia; Adults https://clinicalprosody.wordpress.com/2016/09/30/1340 

 

Limited Evidence

  • The authors provide objectives and strategies for clinicians wishing to include music in their treatment of children in the early stages of communication development. They report marked increase in purposeful reaching for objects (Witt & Steele, 1984.) Developmental Delay; Children https://clinicalprosody.wordpress.com/2016/10/13/witt-steele-1984/

 

Evidence contraindicates the use of the intervention for the specific outcome(s)

 

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IMITATION OUTCOMES

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Strong Evidence, minus

 

Moderate Evidence, plus

 

 

Moderate Evidence, minus

  • This Systematic Review (SR) with broad criteria is concerned with a variety of treatments and outcomes. The authors of the SR rated sources for quality of certainty of results. The source that targeted imitation performance on the PICAC was rated as Preponderant (Murray et al., 2014.) Childhood Apraxia of Speech; Children https://wordpress.com/post/clinicalprosody.wordpress.com/1329

 

Fair Evidence, plus

 

Limited Evidence

  • This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes. The outcomes associated with imitation improved (da Fontoura et al., 2014.) Aphasia, Adults https://clinicalprosody.wordpress.com/2016/12/05/da-fontoura-et-al-2014/

 

Poor Evidence

 

  • This program description with associated case studies is an example of early work (1974) supporting the view that music can play a role in intervention with children with developmental delays. The author described positive changes (but not documentary evidence of progress) in imitation (Brown, 1974.) Developmental Delay; Children https://clinicalprosody.wordpress.com/2016/04/23/brown-1974/

 

Contraindicated

  • Overall results of 2 Experiments involved French children diagnosed with reading impairments treated with Cognitive-Musical Training (CMT) indicated no significant improvement in repetition of nonsense words or of digits (Habib et al., 2016.) Literacy Problems; Children  https://clinicalprosody.wordpress.com/2017/03/12/habib-et-al-2016/

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INITIATION OF SPEAKING TURNS/CONVERSATION OUTCOMES

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Strong Evidence, minus

  • This prospective, randomized group design with controls investigation supports the effectiveness of the Lee Silverman Voice Treatment (LSVT) and respiration-based (R) therapy in improving initiation of conversation, monotonicity, hoarseness, intelligibility (Ramig et al., 1995.)   Parkinson’s Disease; Adult https://clinicalprosody.wordpress.com/2014/02/04/ramig-et-al-1995/

 

Moderate Evidence, plus

 

Moderate Evidence

 

 

Fair Evidence, plus

 

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INTELLIGIBILITY OUTCOMES

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Strong Evidence, minus

 

  • Comparisons of Face-to-face (FTF) and Online versions of Lee Silverman Voice Treatment (LVST) revealed that both FTF and Online interventions resulted in similar changes in several some measures of intelligibility (i.e., perceived ease of understanding and reduced requests for repetitions.) Moreover, there were no significant differences between the Online and FTF versions of LVST (Theodoros et al., 2016.) Parkinson’s Disease; Adults  https://clinicalprosody.wordpress.com/2017/02/11/theodoros-et-al-2016/

 

 

 

Moderate Evidence, plus

 

Moderate Evidence

  • Short term therapy based on Halliday (1970) with and without visual feedback results in improvements in intelligibility ratings by SLPs. Only the interventions with the visual feedback yields improvements in physician’s ratings of intelligibility (Scott & Caird, 1983.) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/?s=Scott+%26+Caird+%281983%29

 

Moderate Evidence, minus

  • This single group pre-post test intervention experiment yielded results supporting the effectiveness of Lee Silverman Voice Treatment (LVST) in improving intelligibility. Overall, intelligibility significantly improved following LVST and analyses of effectiveness for individuals revealed that 6 of the 8 participants improved significantly (Cannito et al., 2012.) Parkinson’s disease; Adults  https://clinicalprosody.wordpress.com/2016/12/30/cannito-et-al-2012/ 

 

Fair Evidence, plus

  • Dutch speakers diagnosed Parkinson’s disease received an intensive course of speech therapy focusing on rate and intonation to improve intelligibility. Intelligibility improved significantly with a large effect size (Martens et al., 2015.) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2015/11/30/martens-et-al-2015/

 

Fair Evidence

 

Fair Evidence, minus

 

  • In this learning (i.e., not intervention) research, this investigation revealed that any one of 4 computerized rate control strategies could result in improved sentence intelligibility although metered approaches and additive rhythmic approaches seemed better than the cued rhythmic approach (Yorkston et al., 1990.) Parkinson’s Disease, Dysarthria—Ataxic; Dysarthria—Hypokinetic; Adults  https://clinicalprosody.wordpress.com/2015/01/04/yorkston-et-al-1990/

 

Limited Evidence, plus

  • This case study reported improvement in the perception of intelligibility following Combination Treatment which involves Lee Silverman Voice Treatment (LSVT) plus Respiration therapy and Physical therapy but not with LSVT alone (Solomon et al., 2001). Traumatic Brain Injury, Hypokinetic- spastic dysarthria; Adult  https://clinicalprosody.wordpress.com/2014/04/23/solomom-et-al-2001

 

Limited Evidence 

  • Case studies provide limited and inconsistent support of intonation intervention for improving intelligibility. However, the investigators have an interesting definition of intelligibility (Grube et al., 1986.) Speech Sound Disorders, Intelligibility Problems; Children https://clinicalprosody.wordpress.com/2013/06/02/grube-et-al-1986/
  • The evidence from these case studies inconsistently support the use of delayed auditory feedback (DAF) as a compensatory device to improve intelligibility in reading and conversation. The changes do not generalize to speech when the DAF is not worn (Hanson & Metter, 1983.) Parkinson’s Disease; Adult https://clinicalprosody.wordpress.com/?s=Hanson
  • These case studies provide promising information that music therapy with concurrent speech-language therapy can result in limited improvement in intelligibility on the Sentence Intelligibility Test and strong improvement in intelligibility in spontaneous speech (Tamplin, 2008.) Dysarthria; Adult, Adolescent https://clinicalprosody.wordpress.com/2013/06/14/tamplin-2008/
  • The results of this case study suggest a combined intervention (Lee Silverman Voice Treatment and the Ryan Fluency Program) was moderately successful in improving intelligibility in a boxer with ataxic dysarthria. However, the patient’s self-perception of his communication skills decreased markedly (McMicken et al., 2011). Ataxic Dysarthria; Adult https://clinicalprosody.wordpress.com/2014/08/16/mcmicken-et-al-2011/

 

Limited Evidence, minus

  • Three case studies suggest that Lee Silverman Voice Treatment has variable and limited effectiveness in improving intelligibility of single words (Countryman et al., 1994.) Parkinsonian Plus Syndromes; Adult https://clinicalprosody.wordpress.com/?s=Countryman
  • This traditional narrative review provides a guide to incorporating Lee Silverman Voice Treatment (LVST-Loud) into telepractice and reviews research documenting its effectiveness for intelligibility as well as its costs and P satisfaction (Theodoros & Ramig, 2011) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2014/05/23/theodoros-ramig-2011

 

Minimal Evidence

 

No Evidence Provided

 

Not Graded

  • Both metered and patterned rhythmic speech resulted in improved word accuracy in this clinically related research. Neither form of rhythmic speech cueing was more effective. However, both forms of rhythmic cueing were most effective with Ps who were classified as severely impaired speakers and the optimum rate of speech was the habitual speaking rate or 60% of habitual speaking rate (Thaut et al., 2001.) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2016/07/07/thaut-et-al-2001/

 

Contraindicated

 

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INTERACTION OUTCOMES

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Strong Evidence, minus

  • MT (melodic therapy) yielded significantly better outcomes of discourse informativeness than other MIT adaptations using rhythm only (RT) or spoken words only (ST.) All 3 interventions (MT, RT, ST) resulted in significant improvements in the imitation of trained words but improvement with untrained words was consistently better with MT than with RT or ST. None of the interventions resulted in improved measures of diadochokinetic rate or of mood (Zumbansen et al., 2014.) Broca’s Aphasia; Adults https://clinicalprosody.wordpress.com/2016/03/16/zumbasen-et-al-2014/

 

Moderate Evidence, plus

 

 

Fair Evidence, plus

 

 

Limited Evidence

 

  • This program description with associated case studies is an example of early work (1974) supporting the view that music can play a role in intervention with children with developmental delays. The author described positive changes (but not documentary evidence of progress) in early communication/interaction skills (Brown, 1974.) Developmental Delay; Children https://clinicalprosody.wordpress.com/2016/04/23/brown-1974/

 

Limited Evidence, minus

  • This descriptive case study describes a music therapy based intervention in which by following the child’s lead he was able to help the child establish a link between the child’s actions and the music played by the music therapist and eventually establish eye contact and beginning forms of interpersonal communication (Saperston, 1973). Autism Spectrum Disorders, Developmental Delay; Child https://clinicalprosody.wordpress.com/2015/01/13/saperston-1973/

 

 

Minimal Evidence 

  • This program description with associated case studies is an example of early work (1974) supporting the view that music can play a role in intervention with children with developmental delays. The author described positive changes (but not documentary evidence of progress) in early communication/interaction skills (Brown, 1974.) Developmental Delay; Children https://clinicalprosody.wordpress.com/2016/04/23/brown-1974/

 

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LANGUAGE DEVELOPMENT –GENERAL OUTCOMES

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Limited Evidence

  • This Narrative (or Traditional) review of the literature contains reviews of several investigations suggesting that the inclusion of music/singing in intervention directed toward the development of language in children can be associated with success (Michel & May, 1974.) General Language Impairment; Children https://clinicalprosody.wordpress.com/2016/04/27/michel-may-1974/

 

Limited Evidence, minus

 

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LITERACY OUTCOMES

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Moderate Evidence, plus

 

  • The results of 3 single subject experimental design investigations indicate that Interactive Metronome training paired with traditional training does not result in improved reading fluency in children (Lewis, 2015.) Literacy problems, Reading Fluency problems; Children https://clinicalprosody.wordpress.com/2016/02/20/lewis-2015/

 

Moderate Evidence

  • Moderate improvement in comprehension of read stories, as assessed using a cued recall, during expressive storybook reading. Not an intervention study but is clinically related (Mira & Schwanenflugel, 2013.) Typically Developing; Children https://clinicalprosody.wordpress.com/2013/12/27/592/

 

Fair Evidence

  • Overall results of 2 Experiments involved French children diagnosed with reading impairments treated with Cognitive-Musical Training (CMT) indicated some significant improvements in some measures of Phoneme Fusion, Visual Identification of Letters, and Word Reading (Habib et al., 2016.) Literacy Problems; Children https://clinicalprosody.wordpress.com/2017/03/12/habib-et-al-2016

 

Fair Evidence, minus

 

  • This single group investigation revealed that a comprehension-based Readers Theatre intervention for 2nd graders who are English Language Learners can improve timing (phrasing), intonation, and stress (i.e., fluency) of oral reading (Daly, 2009). Literacy (fluency), ELL; Children https://clinicalprosody.wordpress.com/2014/06/02/daly-2009/

 

Limited Evidence, plus

  • This case study described a case in which a woman with aphasia and apraxia profited from the addition of singing into her therapy programming when traditional therapy had failed. Evidence of progress took the form of improved performance on the graphic portion of the Profile of Communicative Ability (Keith & Aronson, 1974.) Apraxia, Aphasia; Adults https://clinicalprosody.wordpress.com/2016/09/30/1340

 

Limited Evidence

 

  • This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes. The outcomes associated with literacy tended to improve (da Fontoura et al., 2014.) Aphasia, Adults https://clinicalprosody.wordpress.com/2016/12/05/da-fontoura-et-al-2014/

 

Limited Evidence, minus

 

 

No Intervention Evidence Provided 

  • This expert opinion presents evidence from the literature that dysfluent reading may be associated with teacher behaviors. Although the focus of the teaching strategies was dysfluent reading, these strategies could be helpful with prosodic problems (Allington, 2006.) Literacy problems; Children, Adolescent https://clinicalprosody.wordpress.com/2014/03/16/allington-2006/

 

 

  • Tune in™ to Reading (TITR) is a music based interactive software program. The author of this expert opinion reviewed the literature and selected aspects of the program and noted that TITR has potential to treat children with cochlear implants (CI) (Eier, 2013.) Deafness, Hearing Loss, Cochlear Implants; Children https://clinicalprosody.wordpress.com/2015/10/31/eier-2013/

 

Evidence Contraindicates Use

 

  • The results of 3 single subject experimental design investigations indicate that Interactive Metronome training paired with traditional training does not result in improved reading fluency in children (Lewis, 2015.) Literacy problems, Reading Fluency problems; Children https://clinicalprosody.wordpress.com/2016/02/20/lewis-2015/

 

________________________________________________________

MEMORY OUTCOMES

_______________________________________________________

Moderate Evidence, plus

 

Fair Evidence

 

Limited Evidence

  • This single case study investigated the effect of an adapted form of Melodic Intonation Therapy (AMIT) on a patient (P) with Broca’s Aphasia who was a speaker of Brazilian Portuguese. The investigators monitored 73 outcomes. The outcomes associated with memory tended to improve (da Fontoura et al., 2014.) Aphasia, Adults https://clinicalprosody.wordpress.com/2016/12/05/da-fontoura-et-al-2014/ 

________________________________________________________

MLU/WORDS PER MINUTE OUTCOMES

________________________________________________________

 Moderate Evidence, minus

  • This Systematic Review (SR) with broad criteria is concerned with a variety of treatments and outcomes. The authors of the SR rated sources for quality of certainty of results. The source that targeted MLU was rated as Suggestive (Murray et al., 2014.) Childhood Apraxia of Speech; Children https://wordpress.com/post/clinicalprosody.wordpress.com/1329

 

Fair Evidence, plus

 

Fair Evidence, minus

 

Limited Evidence, plus

 

Limited Evidence

•  Case studies provide limited and inconsistent support of intonation intervention for improving perceived length of utterance (Grube et al., 1986.) Intelligibility Problems; Speech Sound Disorders; Child https://clinicalprosody.wordpress.com/2013/06/02/grube-et-al-1986/

 

Limited Evidence, minus

 

Evidence ContraIndicates Use

_________________________________________________________

MOTOR OUTCOMES (nonspeech)

_______________________________________________________

Not graded (clinically related, not intervention research)

 

Contraindicated

 

_______________________________________________________

MORPHOSYNTAX OUTCOMES

______________________________________________________

Limited Evidence, plus

 

Limited Evidence, minus

 

Evidence Contraindicates The Use Of The Intervention For The Specific Outcomes 

 

 

__________________________________________________________

NARRATION (Story Telling/Retelling)

_________________________________________________________

Moderate Evidence, plus

 

____________________________________________________

NORMALCY/NATURALNESS OUTCOMES

___________________________________________________

Moderate Evidence

 

 

Fair Evidence, plus

 

  • These case studies provide variable support for an intervention to improve contrastive stress, voice quality (pitch and loudness), articulatory precision, and naturalness but not verbal repairing (Hartelius et al., 1997.) Multiple Sclerosis; Adult https://clinicalprosody.wordpress.com/?s=Hartelius

 

Limited Evidence

 

Minimal Evidence

  • These case studies yielded minimally applicable clinical results because the sessions were very brief. The perceptual measures of abnormality decreased following both interventions: Lee Silverman Voice Treatment and intonation only therapy (Kobayashi et al., 2004.) Dysarthria; Adult https://clinicalprosody.wordpress.com/2013/11/13/kobayashi-et-al-2004/

 

Contraindicated

  • In this learning (i.e., not intervention) research, this investigation revealed that both metered and rhythmic computerized rate control strategies resulted in decreased speech naturalness rating for Ps with hypokinetic dysarthria. For the Ps with hypokinetic dysarthria, naturalness rating improved with rhythmic approached and decreased with metered approaches (Yorkston et al., 1990.) Parkinson’s Disease, Dysarthria—Ataxic; Dysarthria—Hypokinetic; Adults https://clinicalprosody.wordpress.com/2015/01/04/yorkston-et-al-1990/

 

____________________________________________________

ON-TASK BEHAVIOR OUTCOMES

_____________________________________________________

Fair Evidence

 

_________________________________________________

ORAL MOTOR SKILL OUTCOMES

–––––––––––––––––––––––––––––––––––––––––––––––––

Strong Evidence, minus

 

 

Limited Evidence, plus

  • This case study reported improvement in some measures of breathing following Lee Silverman Voice Treatment (LSVT) and Combination Treatment which involves LSVT plus Respiration therapy and Physical therapy (Solomon et al., 2001). Traumatic Brain Injury, Hypokinetic- spastic dysarthria; Adult https://clinicalprosody.wordpress.com/2014/04/23/solomom-et-al-2001

 

Limited Evidence

  • The results of this case study suggest a combined intervention (Lee Silverman Voice Treatment and the Ryan Fluency Program) was moderately successful in improving diadokokenesis skills in a boxer with ataxic dysarthria. However, the patient’s self-perception of his communication skills decreased markedly (McMicken et al., 2011). Ataxic Dysarthria; Adult https://clinicalprosody.wordpress.com/2014/08/16/mcmicken-et-al-2011/

 

Minimal Evidence

  • This case illustration provides limited support for the use of an intervention using music (rhythm, melody/pitch) to improve responses to tongue exercised speech in an adult with apraxia and aphasia following a cerebral vascular accident (Rogers & Fleming, 1981.) Apraxia, Aphasia; Adults https://clinicalprosody.wordpress.com/2015/09/30/rogers-fleming-1981/

 

 

Evidence Contraindicates The Use Of The Intervention For The Specific Outcomes

 

 

 

__________________________________________________________

PHONOLOGY/PHONOLOGICAL PROCESSES OUTCOMES*

*(see also Articulation/Speech Sound Outcomes)

__________________________________________________________

Strong Evidence, minus

 

Fair Evidence, plus

•  Spanish language dominant Mexican American children suppressed syllable deletion as the result of the traditional phonological process (PP) therapy as well as music-based (phonological process (MT) therapy. There was some evidence suggesting that the children who receive MT therapy progressed more rapidly than the PP therapy (Crutchfield, 2014.) Speech Sound Disorder, Phonological Process Disorder; Children https://clinicalprosody.wordpress.com/2016/05/21/crutch-field-2104/

 

Fair Evidence, minus

 

Limited Evidence

 

___________________________________________________

PICTURE DESCRIPTION OUTCOMES

__________________________________________________

Fair Evidence, plus

 

__________________________________________________

POINTING OUTCOMES

__________________________________________________

Moderate Evidence

 

Limited Evidence, plus

 

_____________________________________________________

PRAGMATIC OUTCOMES

_____________________________________________________

Moderate Evidence

 

 

 

Moderate Evidence, minus

  • Computer-assisted technologies have potential to improve comprehension of prosodic affect and sarcasm/metaphors in individuals with autism spectrum disorders (ASD) but it is not clear that it is more effective than conventional interventions (Ploog et al., 2013.) Autism Spectrum Disorders, Asperger Syndrome; Children https://clinicalprosody.wordpress.com/2016/03/28/ploog-et-al-2013/

 

 

Fair Evidence, plus

 

Fair Evidence, minus

 

Limited Evidence

 

Limited Evidence, minus

  • The authors explained the rationale for co-treatment of communication disorders by music therapists (MT) and speech-language pathologists (SLP) and described the strategy using a single case. The dependent measure was classroom engagement (Geist et al., 2008). Language Impairment; Children https://clinicalprosody.wordpress.com/2014/05/14/geist-et-al-2008/

 

______________________________________________________

PRODUCTION OF PHRASES OUTCOMES

______________________________________________________

Moderate Evidence, minus

  • This investigation demonstrates the effectiveness music therapy in improving production of simple sentences in developmentally delayed children from Taiwan who were speakers of Mandarin Chinese (Lee, 2008). Speech Impairment, Language Impairment; Children https://clinicalprosody.wordpress.com/2014/07/23/lee-2008/

 

Fair Evidence, plus

 

No Evidence Provided

 

____________________________________________________

PRODUCTION OF WORDS OUTCOMES

_____________________________________________________

Moderate Evidence

 

 

Moderate Evidence, minus

 

  • This Systematic Review (SR) with broad criteria is concerned with a variety of treatments and outcomes. The authors of the SR rated sources for quality of certainty of results. The source that targeted naming performance on the PICAC was rated as Preponderant (Murray et al., 2014.) Childhood Apraxia of Speech; Children https://wordpress.com/post/clinicalprosody.wordpress.com/132

 

  • This investigation demonstrates the effectiveness music therapy in improving production of single words in developmentally delayed children from Taiwan who were speakers of Mandarin Chinese (Lee, 2008). Speech Impairment, Language Impairment, Developmental Delay; Children https://clinicalprosody.wordpress.com/2014/07/23/lee-2008/

 

Fair Evidence, plus

 

Fair Evidence

 

Limited Evidence, plus

  • These case studies provide limited support for using Melodic Intonation Therapy (MIT) as a warm-up prior to traditional therapy session to improve performance on some subtests of Porch Index of Communicative Ability in Children (PICAC), naming of items, increased sentence length and complexity, and increased intelligibility (Krauss & Galloway, 1982.) Expressive Language Delay and Childhood Apraxia of Speech; Children https://clinicalprosody.wordpress.com/2013/06/23/krauss-galloway-1982/

 

Ineffective

  • The results of this small group investigation suggest that a music-based intervention to improve expressive language in preschool children was not successful in improving expressive vocabulary scores (Hoskins, 1988). Cognitive Impairment, Developmental Delay; Children-preschool https://clinicalprosody.wordpress.com/2015/10/16/hoskins-1988/

 

____________________________________________________

PSYCHOLOGICAL STATUS OUTCOMES

_____________________________________________________

Strong Evidence, minus

 

Moderate Evidence, plus

 

Fair Evidence, plus

 

Limited Evidence

 

  • The results of 3 single subject experimental design investigations indicate that Interactive Metronome training paired with traditional training does not result in improved reading fluency in children (Lewis, 2015.) Literacy problems, Reading Fluency problems; Children    https://clinicalprosody.wordpress.com/2016/02/20/lewis-2015/

 

 

Evidence Contraindicates Use

 

––––––––––––––––––––––––––––––––––––––––––––––––––––

RATE OF VERBALIZATION OUTCOMES

–––––––––––––––––––––––––––––––––––––––––––––––––––––

Moderate Evidence

 

 

 

Fair Evidence

 

___________________________________________________

REPETITIVENESS OUTCOMES

__________________________________________________

Fair Evidence, plus

 

Minimal Evidence

 

___________________________________________________

RESONANCE OUTCOMES

______________________________________________

Fair Evidence, minus

 

Evidence contraindicates the use of the intervention for the specific outcome(s)

 

___________________________________________

RESPIRATION OUTCOMES

__________________________________________

Fair Evidence, minus

 

–––––––––––––––––––––––––––––––––––––––––––––––––––––––

RESPONDING TO QUESTIONS/COMMANDS OUTCOMES

_________________________________________________________

Moderate Evidence

 

Fair Evidence, plus

 

Limited Evidence 

  • The authors provide objectives and strategies for clinicians wishing to include music in their treatment of children in the early stages of communication development. They report a limited increase in responding to their names (Witt & Steele, 1984.) Developmental Delay; Children https://clinicalprosody.wordpress.com/2016/10/13/witt-steele-1984/

 

Limited Evidence, minus

 

_________________________________________________________

SEMANTICS OUTCOMES

––––––––––––––––––––––––––––––––––––––––––––––––––––––––

Moderate Plus Evidence

  • Both Song and Nonsong treatments were effective in teaching vocabulary comprehension to school-aged Iranian English language learners. However, Song and Nonsong group outcomes were not significantly different from one another at the post intervention testing (Akbarpour & Roohani, 2015.) English Language Learners; Children https://clinicalprosody.wordpress.com/2016/11/11/akbarpour-roohani-2015/

 

Moderate Evidence

  • This single-subject experimental design investigation revealed that there was no change in the proportion of conversational nouns, verbs, adjectives/adverbs, and function words as the result of the drug Bromocriptine (Raymer et al., 2001.)   Aphasia, Crossed Nonfluent Aphasia; Adult https://clinicalprosody.wordpress.com/2015/09/09/raymer-et-al-2001/

 

Fair Evidence, minus

 

No Treatment Evidence Provided

 

_____________________________________________

SINGING OUTCOMES

______________________________________________

Fair Evidence, plus

 

______________________________________________

SOCIAL INTERACTION OUTCOMES

_______________________________________________

Fair Evidence, plus

 

Limited Evidence, minus

 

____________________________________

TURN TAKING OUTCOMES

____________________________________

Moderate Evidence, plus

 

Fair Evidence, plus

 

 

Limited Evidence, minus

 

__________________________________________

VERBAL EXPRESSION OUTCOMES

__________________________________________

Fair Evidence, plus

 

Limited Evidence, plus

  • This case study described a case in which a woman with aphasia and apraxia profited from the addition of singing into her therapy programming when traditional therapy had failed. Evidence of progress took the form of improved performance on the verbal portion of the Profile of Communicative Ability (Keith & Aronson, 1974.) Apraxia, Aphasia; Adults https://clinicalprosody.wordpress.com/2016/09/30/1340

 

Limited Evidence

  • Only a portion of this comprehensive intervention involved using prosody outcomes to treat speech production outcome. The intervention was moderately effective yielded moderate progress with respect to speech production (Ertmer et al. 2002.) Hearing Loss, Cochlear Implants; Children https://clinicalprosody.wordpress.com/2016/01/26/ertmer-et-al-2002/

 

Minimal Evidence

 

  • This case illustration provides limited support for the use of an intervention using music (rhythm, melody/pitch) to improve automatic speech, vowels, progressively more complex jargon, and confrontation naming in an adult with apraxia and aphasia following a cerebral vascular accident (Rogers & Fleming, 1981.) Apraxia, Aphasia; Adults https://clinicalprosody.wordpress.com/2015/09/30/rogers-fleming-1981/

 

No Evidence Provided

 

 

__________________________________________

VERBAL REPAIRING OUTCOMES

___________________________________________

Evidence contraindicates the use of the intervention for the specific outcome

 

––––––––––––––––––––––––––––––––––––––––––––––––––

 VOCALIZATION/VERBALIZATION OUTCOMES

–––––––––––––––––––––––––––––––––––––––––––––––––––

Moderate Evidence

 

Moderate Evidence, minus

  • This investigation demonstrates the effectiveness music therapy in improving attention in developmentally delayed children from Taiwan who were speakers of Mandarin Chinese (Lee, 2008). Speech Impairment, Language Impairment, Developmental Delay; Children https://clinicalprosody.wordpress.com/2014/07/23/lee-2008/

 

Fair Evidence, plus

 

Limited Evidence

 

  • This program description with associated case studies is an example of early work (1974) supporting the view that music can play a role in intervention with children with developmental delays. The author described positive changes (but not documentary evidence of progress) in pre-speech vocalizations (Brown, 1974.) Developmental Delay; Children   https://clinicalprosody.wordpress.com/2016/04/23/brown-1974/

 

Limited Evidence, minus

 

–––––––––––––––––––––––––––––––––––––––––––––

VOICE QUALITY OUTCOMES

__________________________________________________

 

Strong Evidence, minus

 

 

Moderate Evidence

 

 

Fair Evidence, minus

  • Boys with muscle tension dysphonia (MTD) received an intervention focusing on awareness, relaxation, breathing, phonation, and homework. The results of this retrospective, descriptive, single group investigation revealed progress several aspects of voice quality and in the reduction of hypercontraction (Lee & Son, 2005.) Voice Quality, Muscle Tension Dysphonia; Children https://clinicalprosody.wordpress.com/2015/12/07/lee-son-2005/

 

 

Limited Evidence, plus

 

Limited Evidence

  • This preliminary report suggests that a computer game that presents acoustic feedback has some promise in reducing pitch breaks and modulating pitch range (Hoque et al., 2009.) Autism Spectrum Disorder; Adolescent https://clinicalprosody.wordpress.com/?s=Hoque

 

  • This case study reported limited improvement in perception of voice quality/vocal press following Lee Silverman Voice Treatment (LSVT) and not for Combination Treatment which involves LSVT plus Respiration therapy and Physical therapy (Solomon et al., 2001). Traumatic Brain Injury, Hypokinetic- spastic dysarthria; Adult https://clinicalprosody.wordpress.com/2014/04/23/solomom-et-al-2001

 

Limited Evidence, minus

 

  • This traditional narrative review provides a guide to incorporating Lee Silverman Voice Treatment (LVST-Loud) into telepractice and reviews research documenting its effectiveness for breathiness and overall voice quality as well as its costs and P satisfaction (Theodoros & Ramig, 2011) Parkinson’s Disease; Adults https://clinicalprosody.wordpress.com/2014/05/23/theodoros-ramig-2011

 

 

Minimal Evidence

  • These case studies yielded minimally applicable clinical results because the sessions were very brief. The perceptual measures of voice quality improved following both interventions—Lee Silverman Voice Treatment and intonation only therapy (Kobayashi et al., 2004.)  Dysarthria; Adult https://clinicalprosody.wordpress.com/2013/11/13/kobayashi-et-al-2004/

 

Evidence Does Not Support Use

  • This case study failed to observe improvement in perceived vocal roughness following Lee Silverman Voice Treatment (LSVT) and Combination Treatment which involves LSVT plus Respiration therapy and Physical therapy (Solomon et al., 2001). Traumatic Brain Injury, Hypokinetic- spastic dysarthria; Adult https://clinicalprosody.wordpress.com/2014/04/23/solomom-et-al-2001

 

___________________________________________

VOICE ONSET TIME OUTCOMES

––––––––––––––––––––––––––––––––––––––––––––––

Moderate Evidence, plus

 

––––––––––––––––––––––––––––––––––––––––—–––––––––

 WORD/SOUND DISCRIMINATION OUTCOMES

_____________________________________________________

Fair Evidence, plus

 

Limited Evidence

  • This Narrative (or Traditional) review of the literature contains reviews of several investigations suggesting that the inclusion of music/singing in intervention directed toward discrimination can be associated with improvement (Michel & May, 1974.) General Language Impairment; Children https://clinicalprosody.wordpress.com/2016/04/27/michel-may-1974/

 

_______________________________________________

WORD FINDING OUTCOMES

_________________________________________________

Limited Evidence

 

 

 

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